Autologous Bone Marrow Stem Cell Transplantation in Liver Cirrhosis after Correcting Nutritional Anomalies, A Controlled Clinical Study
Liver transplantation is the gold standard approach for decompensated liver cirrhosis. In recent years, stem cell therapy has raised hopes that adjusting some clinical and laboratory parameters could lead to successful treatments for this disease. Cirrhotic patients may have multiple systemic abnorm...
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| Veröffentlicht in: | Cell journal (Yakhteh) 2019-10, Vol.21 (3), p.268-273 |
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| creator | Esmaeilzadeh, Abbas Ommati, Homeira Kooshyar, Mohammad Mahdi Jarahi, Lida Akhavan Rezayat, Kambiz Saberi, Samaneh Vosough, Massoud Ghassemi, Ali |
| description | Liver transplantation is the gold standard approach for decompensated liver cirrhosis. In recent years, stem cell therapy has raised hopes that adjusting some clinical and laboratory parameters could lead to successful treatments for this disease. Cirrhotic patients may have multiple systemic abnormalities in peripheral blood and irregular cell populations in bone marrow (BM). Correcting these abnormalities before BM aspiration may improve the effectiveness of cell-based therapy of liver cirrhosis.
In this controlled clinical trial study, 20 patients with decompensated liver cirrhosis were enrolled. Patients were randomly assigned to control and experimental groups. Blood samples were obtained to measure vitamin B12, folate, serum iron, total iron bonding capacity (TIBC) and ferritin before any intervention. Furthermore, the iron storage and fibrosis level in BM biopsies, as well as the percentage of different cell populations, were evaluated. Prior to cell isolation for transplantation, we performed palliative supplement therapy followed by a correction of nutritional deficiencies. Mononuclear cells (MNCs) were then isolated from BM aspirates and transfused through peripheral vein in patients in the experimental group. The model of end-stage liver disease (MELD) score, The international normalized ratio (INR), serum albumin and bilirubin levels were assessed at 0 (baseline), 3 and 6 months after cell transplantation.
The MELD score (P=0.0001), INR (P=0.012), bilirubin (P |
| doi_str_mv | 10.22074/cellj.2019.6108 |
| format | Article |
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In this controlled clinical trial study, 20 patients with decompensated liver cirrhosis were enrolled. Patients were randomly assigned to control and experimental groups. Blood samples were obtained to measure vitamin B12, folate, serum iron, total iron bonding capacity (TIBC) and ferritin before any intervention. Furthermore, the iron storage and fibrosis level in BM biopsies, as well as the percentage of different cell populations, were evaluated. Prior to cell isolation for transplantation, we performed palliative supplement therapy followed by a correction of nutritional deficiencies. Mononuclear cells (MNCs) were then isolated from BM aspirates and transfused through peripheral vein in patients in the experimental group. The model of end-stage liver disease (MELD) score, The international normalized ratio (INR), serum albumin and bilirubin levels were assessed at 0 (baseline), 3 and 6 months after cell transplantation.
The MELD score (P=0.0001), INR (P=0.012), bilirubin (P<0.0001) and total albumin (P<0.0001) levels improved significantly in the experimental group after cell transplantation compared to the baseline and control groups. Moreover, the increase in serum albumin levels of patients in the experimental group was statistically significant 6 months after transplantation.
We have successfully improved the conditions of preparing -BM-derived stem cells for transplantation. Although these cells are relatively safe and have been shown to improve some clinical signs and symptoms temporarily, there need to be more basic studies regarding the preparation steps for effective clinical use (Registration number: IRCT2014091919217N1).</description><identifier>ISSN: 2228-5806</identifier><identifier>EISSN: 2228-5814</identifier><identifier>DOI: 10.22074/cellj.2019.6108</identifier><identifier>PMID: 31210432</identifier><language>eng</language><publisher>Iran: Royan Institute of Iran</publisher><subject>Abnormalities ; Albumin ; Anomalies ; Autografts ; Bilirubin ; Biopsy ; Blood ; Bone marrow ; Bone marrow transplantation ; Cell therapy ; Cirrhosis ; Clinical trials ; Control methods ; Etiology ; Ferritin ; Fibrosis ; Folic acid ; Hepatitis ; Hepatocytes ; Iron ; Leukocytes (mononuclear) ; Levels ; Liver ; Liver cirrhosis ; Liver diseases ; Liver transplantation ; Medical treatment ; Nutrient deficiency ; Original ; Patients ; Peripheral blood ; Populations ; Researchers ; Serum albumin ; Signs and symptoms ; Statistical analysis ; Statistical methods ; Stem cell transplantation ; Stem cells ; Studies ; Therapy ; Transplantation ; Vitamin B ; Vitamin B12</subject><ispartof>Cell journal (Yakhteh), 2019-10, Vol.21 (3), p.268-273</ispartof><rights>Copyright© by Royan Institute. All rights reserved.</rights><rights>2019. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at https://celljournal.org/journal/article/fulltext/autologous-bone-marrow-stem-cell-transplantation-in-liver-cirrhosis-after-correcting-nutritional-anomalies-a-controlled-clinical-study.</rights><rights>2019. This work is published under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Cell Journal (Yakhteh) is an open access journal which means the articles are freely available online for any individual author to download and use the providing address. The journal is licensed under a Creative Commons Attribution-Non Commercial 3.0 Unported License which allows the author(s) to hold the copyright without restrictions that is permitting unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-30f7002061bfac387c52b990723a47ec977e827b2f81647ac3647883c8eb6d1c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582418/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582418/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31210432$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Esmaeilzadeh, Abbas</creatorcontrib><creatorcontrib>Ommati, Homeira</creatorcontrib><creatorcontrib>Kooshyar, Mohammad Mahdi</creatorcontrib><creatorcontrib>Jarahi, Lida</creatorcontrib><creatorcontrib>Akhavan Rezayat, Kambiz</creatorcontrib><creatorcontrib>Saberi, Samaneh</creatorcontrib><creatorcontrib>Vosough, Massoud</creatorcontrib><creatorcontrib>Ghassemi, Ali</creatorcontrib><title>Autologous Bone Marrow Stem Cell Transplantation in Liver Cirrhosis after Correcting Nutritional Anomalies, A Controlled Clinical Study</title><title>Cell journal (Yakhteh)</title><addtitle>Cell J</addtitle><description>Liver transplantation is the gold standard approach for decompensated liver cirrhosis. In recent years, stem cell therapy has raised hopes that adjusting some clinical and laboratory parameters could lead to successful treatments for this disease. Cirrhotic patients may have multiple systemic abnormalities in peripheral blood and irregular cell populations in bone marrow (BM). Correcting these abnormalities before BM aspiration may improve the effectiveness of cell-based therapy of liver cirrhosis.
In this controlled clinical trial study, 20 patients with decompensated liver cirrhosis were enrolled. Patients were randomly assigned to control and experimental groups. Blood samples were obtained to measure vitamin B12, folate, serum iron, total iron bonding capacity (TIBC) and ferritin before any intervention. Furthermore, the iron storage and fibrosis level in BM biopsies, as well as the percentage of different cell populations, were evaluated. Prior to cell isolation for transplantation, we performed palliative supplement therapy followed by a correction of nutritional deficiencies. Mononuclear cells (MNCs) were then isolated from BM aspirates and transfused through peripheral vein in patients in the experimental group. The model of end-stage liver disease (MELD) score, The international normalized ratio (INR), serum albumin and bilirubin levels were assessed at 0 (baseline), 3 and 6 months after cell transplantation.
The MELD score (P=0.0001), INR (P=0.012), bilirubin (P<0.0001) and total albumin (P<0.0001) levels improved significantly in the experimental group after cell transplantation compared to the baseline and control groups. Moreover, the increase in serum albumin levels of patients in the experimental group was statistically significant 6 months after transplantation.
We have successfully improved the conditions of preparing -BM-derived stem cells for transplantation. Although these cells are relatively safe and have been shown to improve some clinical signs and symptoms temporarily, there need to be more basic studies regarding the preparation steps for effective clinical use (Registration number: IRCT2014091919217N1).</description><subject>Abnormalities</subject><subject>Albumin</subject><subject>Anomalies</subject><subject>Autografts</subject><subject>Bilirubin</subject><subject>Biopsy</subject><subject>Blood</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Cell therapy</subject><subject>Cirrhosis</subject><subject>Clinical trials</subject><subject>Control methods</subject><subject>Etiology</subject><subject>Ferritin</subject><subject>Fibrosis</subject><subject>Folic acid</subject><subject>Hepatitis</subject><subject>Hepatocytes</subject><subject>Iron</subject><subject>Leukocytes (mononuclear)</subject><subject>Levels</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Liver transplantation</subject><subject>Medical treatment</subject><subject>Nutrient deficiency</subject><subject>Original</subject><subject>Patients</subject><subject>Peripheral blood</subject><subject>Populations</subject><subject>Researchers</subject><subject>Serum albumin</subject><subject>Signs and symptoms</subject><subject>Statistical analysis</subject><subject>Statistical methods</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Studies</subject><subject>Therapy</subject><subject>Transplantation</subject><subject>Vitamin B</subject><subject>Vitamin B12</subject><issn>2228-5806</issn><issn>2228-5814</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kcFuEzEQhi0EolXpnROyxIVDE-yxs7YvldIVbZECHFrOK6_jTR157dT2FvUJ-tp11FIBB-YwY2s-_fNrBqH3lMwBiOCfjfV-OwdC1byhRL5ChwAgZwtJ-euXN2kO0HHOW1KjIUAVvEUHjAIlnMEhelhOJfq4iVPGZzFY_E2nFH_hq2JH3NYB-DrpkHdeh6KLiwG7gFfuzibcupRuYnYZ66Hs_zEla4oLG_x9Ksntae3xMsRRe2fzCV5WJpQUvbdr3HoXnKnAVZnW9-_Qm0H7bI-f6xH6ef7lur2crX5cfG2Xq5lhjSozRgZBCJCG9oM2TAqzgF4pIoBpLqxRQlgJoodB0oaLitQsJTPS9s2aGnaETp90d1M_2rWx1Y_23S65Uaf7LmrX_d0J7qbbxLuuWUjgVFaBT88CKd5ONpdudHl_CR1sXWIHwKHOJkJV9OM_6DZOqe6kUpITtVCMk_9STFJBuQRWqQ9_-n4x_PuS7BH6faJs</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Esmaeilzadeh, Abbas</creator><creator>Ommati, 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Correcting Nutritional Anomalies, A Controlled Clinical Study</title><author>Esmaeilzadeh, Abbas ; Ommati, Homeira ; Kooshyar, Mohammad Mahdi ; Jarahi, Lida ; Akhavan Rezayat, Kambiz ; Saberi, Samaneh ; Vosough, Massoud ; Ghassemi, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-30f7002061bfac387c52b990723a47ec977e827b2f81647ac3647883c8eb6d1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abnormalities</topic><topic>Albumin</topic><topic>Anomalies</topic><topic>Autografts</topic><topic>Bilirubin</topic><topic>Biopsy</topic><topic>Blood</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Cell therapy</topic><topic>Cirrhosis</topic><topic>Clinical trials</topic><topic>Control methods</topic><topic>Etiology</topic><topic>Ferritin</topic><topic>Fibrosis</topic><topic>Folic acid</topic><topic>Hepatitis</topic><topic>Hepatocytes</topic><topic>Iron</topic><topic>Leukocytes (mononuclear)</topic><topic>Levels</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Liver transplantation</topic><topic>Medical treatment</topic><topic>Nutrient deficiency</topic><topic>Original</topic><topic>Patients</topic><topic>Peripheral blood</topic><topic>Populations</topic><topic>Researchers</topic><topic>Serum albumin</topic><topic>Signs and symptoms</topic><topic>Statistical analysis</topic><topic>Statistical methods</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Studies</topic><topic>Therapy</topic><topic>Transplantation</topic><topic>Vitamin B</topic><topic>Vitamin B12</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Esmaeilzadeh, Abbas</creatorcontrib><creatorcontrib>Ommati, Homeira</creatorcontrib><creatorcontrib>Kooshyar, Mohammad 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Esmaeilzadeh, Abbas</au><au>Ommati, Homeira</au><au>Kooshyar, Mohammad Mahdi</au><au>Jarahi, Lida</au><au>Akhavan Rezayat, Kambiz</au><au>Saberi, Samaneh</au><au>Vosough, Massoud</au><au>Ghassemi, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autologous Bone Marrow Stem Cell Transplantation in Liver Cirrhosis after Correcting Nutritional Anomalies, A Controlled Clinical Study</atitle><jtitle>Cell journal (Yakhteh)</jtitle><addtitle>Cell J</addtitle><date>2019-10</date><risdate>2019</risdate><volume>21</volume><issue>3</issue><spage>268</spage><epage>273</epage><pages>268-273</pages><issn>2228-5806</issn><eissn>2228-5814</eissn><abstract>Liver transplantation is the gold standard approach for decompensated liver cirrhosis. In recent years, stem cell therapy has raised hopes that adjusting some clinical and laboratory parameters could lead to successful treatments for this disease. Cirrhotic patients may have multiple systemic abnormalities in peripheral blood and irregular cell populations in bone marrow (BM). Correcting these abnormalities before BM aspiration may improve the effectiveness of cell-based therapy of liver cirrhosis.
In this controlled clinical trial study, 20 patients with decompensated liver cirrhosis were enrolled. Patients were randomly assigned to control and experimental groups. Blood samples were obtained to measure vitamin B12, folate, serum iron, total iron bonding capacity (TIBC) and ferritin before any intervention. Furthermore, the iron storage and fibrosis level in BM biopsies, as well as the percentage of different cell populations, were evaluated. Prior to cell isolation for transplantation, we performed palliative supplement therapy followed by a correction of nutritional deficiencies. Mononuclear cells (MNCs) were then isolated from BM aspirates and transfused through peripheral vein in patients in the experimental group. The model of end-stage liver disease (MELD) score, The international normalized ratio (INR), serum albumin and bilirubin levels were assessed at 0 (baseline), 3 and 6 months after cell transplantation.
The MELD score (P=0.0001), INR (P=0.012), bilirubin (P<0.0001) and total albumin (P<0.0001) levels improved significantly in the experimental group after cell transplantation compared to the baseline and control groups. Moreover, the increase in serum albumin levels of patients in the experimental group was statistically significant 6 months after transplantation.
We have successfully improved the conditions of preparing -BM-derived stem cells for transplantation. Although these cells are relatively safe and have been shown to improve some clinical signs and symptoms temporarily, there need to be more basic studies regarding the preparation steps for effective clinical use (Registration number: IRCT2014091919217N1).</abstract><cop>Iran</cop><pub>Royan Institute of Iran</pub><pmid>31210432</pmid><doi>10.22074/cellj.2019.6108</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; PubMed Central Open Access; PubMed Central |
| subjects | Abnormalities Albumin Anomalies Autografts Bilirubin Biopsy Blood Bone marrow Bone marrow transplantation Cell therapy Cirrhosis Clinical trials Control methods Etiology Ferritin Fibrosis Folic acid Hepatitis Hepatocytes Iron Leukocytes (mononuclear) Levels Liver Liver cirrhosis Liver diseases Liver transplantation Medical treatment Nutrient deficiency Original Patients Peripheral blood Populations Researchers Serum albumin Signs and symptoms Statistical analysis Statistical methods Stem cell transplantation Stem cells Studies Therapy Transplantation Vitamin B Vitamin B12 |
| title | Autologous Bone Marrow Stem Cell Transplantation in Liver Cirrhosis after Correcting Nutritional Anomalies, A Controlled Clinical Study |
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